The Study And Clinical Application Of ~1H-MRS In The Brain Mutiple Sclerosis

Objective: To investigate the appearance and feature of 1H/proton magnetic resonance spectroscopy(1H-MRS) in the brain mutiple sclerosis(MS). To explore the clinical application and value of 1 H-MRS in the mutiple sclerosis .Materials and Methods: 1H-MRS was carried out in 20 patients and 20 normal control subjects. All patients were have diagnosed brain MS with fully clinical data and conventional MRI(cMRI) including T1WI T2WI FLAIR sequences and Gd-DTPA ehancement scanning. The examination included brain lesions and nomal appearing white matter(NAWM) on cMRI. The voxel of interesting(VOI) of the studied objects was examed by the single-voxel spectroscopy(SVS). The peaks of N-acetyi-aspartate(NAA) choline(Cho) creatine/phosphocreatine(Cr/Cr2) of VOI were abserved by point resolved spectroscopy(PRESS) sequence and chemical shift selective saturation(CHESS). The ratios of NAA/Cr, Cho/Cr, NAA/Cho were studied and compared with those of control group. Results:There was a significicant decrease in the the ratios of NAA/Cr, NAA/Cho in the lesions of the MS patients compared with normal control group(p<0.05). The ratio of Cho/Cr in the lesions was obviously elevated(p<0.05). The change of ratios of NAA/Cr, NAA/Cho and Cho/Cr in the NAWM was found the indentical tendency .Gd enhancing lesions compared with the unenhancing lesions, the ratio of Cho/Cr increased. But the ratio NAA/Cr was not found statistical difference between them. Conclusion:1H-MRS can provide more pathologic and biochemical imfomation about MS.It can provid specific and quautitative imfomation about two of the major pathologic aspects of MS including the active inflammatory/demyelinating process and axonal injury. Active demyelinating process produces changes in the resonances from Cho. Axonal injury and loss can be specifily quantified through the decrease of NAA.The NAWM is normal on cMRI, but is not normal on 1H-MRS. 1H-MRS provides an effective method in vivo study for clinical research in MS.It is helpful for the diagnosis anddifferentiation of MS. 1H-MRS measure also has potential value in the jugement and prognosis of neurologic impairment and the evaluation of therapeutic efficacy.